As the health care debate continues, I wanted to look back at the costs of treatment for my wife’s cancer, as well as what was and wasn’t covered, and how our insurance and financial situation could have so easily bankrupted us.

I started by pulling up the total medical charges she accrued from December of last year through the end of August, when she passed away. That total came to $1,888,934.72

We were fortunate to have very good health insurance coverage. Of that total, we paid $1811.24 out of pocket in co-pays. (This doesn’t count all the other expenses, like food and transportation and lodging as we went back and forth to various hospitals, and so on.)

In other words, without health insurance, we would have been on the hook for close to two million dollars of medical bills over the course of nine months.

Back in 2015, when Amy was working full time at CMH, we decided I would try to quit my day job and write full-time. She would provide the salary and benefits, while I would bring in all that shiny author coin. Only my bosses at the day job didn’t want me to go, so they worked out a quarter-time position where I’d be able to work primarily from home. It meant a small but steady paycheck, and thanks to a clause in the Affordable Care Act, I was able to continue getting our health insurance coverage through my own job.

Why is that important? Because Amy’s benefits – vision and dental – ended in February 2019, because she hadn’t been working. On account of her being hospitalized with cancer.

Let’s assume things went as we’d planned. Assume we were on her health insurance. She’d been working full time for years, doing everything “right.” But then she got sick and couldn’t work. 2-3 months later, she lost her insurance.

Looking at the total charges for March through August, we would have been on the hook for $930,076.20 in medical bills.

The alternatives would have been either COBRA coverage, or else finding a plan on the Health Insurance exchange that provided something close to what we had.

COBRA coverage for our vision and dental after we lost Amy’s insurance for those was about $150/month. That stung, but compared to the medical numbers, I’m not gonna complain too much.

Equivalent health insurance coverage for our family, either through COBRA or the exchange, would have been around $2000/month. Better than having to pay a million in medical bills out of pocket, but how many people do you know who can afford an extra $2000/month in unexpected expenses?

Keep in mind, lymphoma is one hell of a preexisting condition. Without protections for those conditions, I’d have been stuck running a million-dollar medical GoFundMe.

I saw a Facebook friend the other day talking about how much he liked and wanted to keep his private insurance. Unfortunately, as I learned this year, employer-based coverage can disappear when you need it most. What’s the point of having great health insurance that only insures you as long as you don’t get too sick?

“What’s the point of having great health insurance that only insures you as long as you don’t get too sick?”
Also: what is the point of having a for-profit healthcare system? Frankly, from where I’m sitting, it looks like profiting off people in their hour of need, taking advantage of those who are least able to fight back. And if someone’s sick but not in a position to be profitable to the healthcare system – what happens then?

Jim C.November 13, 2019 @ 4:47 pm

Holy crap, $2 million! I’m very happy you weren’t saddled with that crazy amount of debt, but that’s a real wake-up call to the fact that health care is incredibly screwed up in this country. I also want to say that I’m always impressed that you are so open and honest on your blog – thank you for sharing, I think you help a lot of people that way.

Fred JonesNovember 13, 2019 @ 7:37 pm

Health care is debacle period. Prices for the same service vary depending on if you have health care, medicaid/medicare or uninsured. It is near impossible to determine if the cost with no insurance would be 2 million or over that or under that. When you start reading into how it works and how they negotiation with the insurance company and how they settle, it is a miracle it works at all.

The best is when your loved one dies and 4 years later the deceased receives a hospital bill (seriously happened to my dad after my mom dies, he ignored it)

John Mark OckerbloomNovember 17, 2019 @ 6:37 pm

Often the amount your insurer actually paid is much less than what was billed. (I’ve seen more than one “explanation of benefits” showing a 5-digit amount billed by the provider, a 3-digit amount paid by the health insurer, and the rest, except for smaller patient co-pay, covered by an “adjustment” by the biller.) Which is one of the other huge problems with the current US system: the real price of a medical service is hugely dependent on how much power the payer has. If you have good insurance, you’re often pretty well set, but if you don’t, you may end up getting squeezed for all the margin the biller wasn’t able to get from the more powerful insurance companies it deals with.

Not to mention that insurance system aside, you were overcharged by a factor of at least 5 times, possibly more, for all the healthcare your wife received. Her bills didn’t have to be nearly two mil and in countries with non-profit universal healthcare, they wouldn’t be that high an amount for the same care. The U.S. spends hundreds of billions more than major European countries on cancer treatments but has higher mortality rates for nearly all of them. And even with the nearly 2 million in charges your insurance was charged from the exchange, the U.S. government was still substantially subsidizing the hospitals and cancer researchers who were also charging you, with considerably less efficiency in payment for services than they get in countries with universal healthcare.

We’ve known for over 30 years that universal healthcare can be funded in the U.S., with multiple possible systems, that it will reduce costs, increase access to healthcare and positive results/fewer deaths and get a better rate of return than what the government and its citizens all need to pay now. But rich people don’t want to have it and lose the profits, and so the U.S. has continually lagged behind the rest of the developed world, and in some rural regions, behind the third world countries.

The one argument they’re still trying to flog is that many people are “happy” with their insurance plans, which is A) not true and B) that a few well-off people are passably happy with a plan does not mean that millions of other people should have to suffer, go without healthcare, beg for their life online and go into medical bankruptcy. Any country with universal healthcare also allows well-off people to buy private, supplementary health insurance plans that let them see doctors and specialists quickly, etc. Nobody who wants to pay thousands for private health insurance will have to go without it in a system with universal healthcare. And those supplementary plans plus any taxes wealthier people might pay into the system will still be cheaper than what they pay now for private insurance. It’s just that other people won’t have to suffer, ration medicine and die because they can’t afford the extortion of the current healthcare system.

I am very glad that your family had the insurance and could get your wife the care she needed. I am so sad for your loss. But to see families go through this and then have their friends witness this pain and trouble, but think they personally are protected and want to cling to a broken, expensive and vicious system of healthcare? I’ve watched too many people I know and love suffer and die from this system when they didn’t have to do so. It’s morally wrong and financially ridiculous. We shouldn’t have to beggar the whole country to get it changed.

Thank you for your honesty and kindness when you are still dealing with so much. I wish support and peace for your family this year.

Kaite FinkNovember 25, 2019 @ 4:41 pm

My family has been fairly lucky. Most of us have had very good coverage when the worst of our health issues have occurred. But it hasn’t been easy. There have been far too many fights to get or keep coverage or to even use the insurance we pay for. We have been luckier than most. Very lucky. And this makes me angry to see people that don’t have the chances I do when they need care. For profit insurers are so against the ethics health care is based upon. Do no harm, my ass….